Provider Demographics
NPI:1285046292
Name:DANDELION NUTRITION PLLC
Entity type:Organization
Organization Name:DANDELION NUTRITION PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HILLYER
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, CD
Authorized Official - Phone:206-799-7010
Mailing Address - Street 1:7520 19TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-4432
Mailing Address - Country:US
Mailing Address - Phone:206-799-7010
Mailing Address - Fax:206-866-0204
Practice Address - Street 1:8301B 5TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-4118
Practice Address - Country:US
Practice Address - Phone:206-799-7010
Practice Address - Fax:206-866-0204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-25
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI60202010133V00000X, 133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Single Specialty